Organization
VIVID PATH LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMBER JORDAN (OWNER)
(865) 217-6080
Entity
Organization
Contact information
Practice address
9050 EXECUTIVE PARK DR STE 109A, KNOXVILLE, TN 37923-4669
(865) 217-6080
Mailing address
9050 EXECUTIVE PARK DR STE 109A, KNOXVILLE, TN 37923-4669
(865) 217-6080
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/10/2025
Last updated
10/03/2025
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